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| __NOTOC__ | | __NOTOC__ |
| ==Acid Base Disorders==
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| == Blood Gas Analysis ==
| | [[Sandbox: wdx]] |
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| {|
| | [[Xyz]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Blood gas analysis
| | |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Vessel
| | [[Abc]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Range
| | # [[Sandbox:Preeti]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Interpretation
| | # [[Lymphoma]] |
| |-
| | # [[Breast lumps differential diagnosis]] |
| ! rowspan="3" align="center" style="background:#DCDCDC;" + |Oxygen Partial Pressure (pO<sub>2</sub>)
| | # [[Neck masses differential diagnosis]] |
| | rowspan="2" align="center" style="background:#DCDCDC;" + |Arterial
| | # [[Leukemia]] |
| | align="left" style="background:#F5F5F5;" + |80 to 100 mmHg
| | {| class="wikitable" |
| | align="left" style="background:#F5F5F5;" + |Normal | | |+ |
| |-
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| | align="left" style="background:#F5F5F5;" + |<80 mmHg
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| | align="left" style="background:#F5F5F5;" + |Hypoxia | |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" + |Venous | | | colspan="2" |[[:Category:Risk calculator]] |
| | align="left" style="background:#F5F5F5;" + |35 to 40 mmHg
| | [[Category:Risk calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal
| |
| |- | | |- |
| ! rowspan="3" align="center" style="background:#DCDCDC;" + |Oxygen Saturation (SO<sub>2</sub>)
| | | colspan="2" |[[Deep vein thrombosis assessment of clinical probability and risk scores]] |
| | rowspan="2" align="center" style="background:#DCDCDC;" + |Arterial
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| | align="left" style="background:#F5F5F5;" + |>95%
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| | align="left" style="background:#F5F5F5;" + |Normal
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| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |<95% | | | colspan="2" |[[Pulmonary embolism assessment of clinical probability and risk scores]] |
| | align="left" style="background:#F5F5F5;" + |Hypoxia
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| |- | | |- |
| | align="center" style="background:#DCDCDC;" + |Venous | | |[[Padua prediction score]] |
| | align="left" style="background:#F5F5F5;" + |70 to 75% | | |[[widget:PaduaVTEscore]] |
| | align="left" style="background:#F5F5F5;" + |Normal
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| |- | | |- |
| ! rowspan="4" align="center" style="background:#DCDCDC;" + |pH
| | |[[IMPROVE risk score calculator]] |
| | rowspan="3" align="center" style="background:#DCDCDC;" + |Arterial
| | |[[Widget:IMPROVEScore]] |
| | align="left" style="background:#F5F5F5;" + |<7.35 | |
| | align="left" style="background:#F5F5F5;" + |Acidemia
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| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |7.35 to 7.45 | | |[[IMPROVEDD risk score calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal | | |[[Widget:IMPROVEDDScore]] |
| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |>7.45 | | |[[Caprini score calculator]] |
| | align="left" style="background:#F5F5F5;" + |Alkalemia | | |[[Widget:CapCal]] |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" + |Venous | | |[[Wells score calculator for DVT]] |
| | align="left" style="background:#F5F5F5;" + |7.26 to 7.46 | | |[[Widget:DVT Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal
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| |- | | |- |
| ! rowspan="4" align="center" style="background:#DCDCDC;" + |Carbon Dioxide Partial Pressure (pCO<sub>2</sub>)
| | |[[Modified Wells score calculator for DVT]] |
| | rowspan="3" align="center" style="background:#DCDCDC;" + |Arterial
| | |[[Widget:DVT Modified Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" + |<35 mmHg | |
| | align="left" style="background:#F5F5F5;" + |Low
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| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |35 to 45 mmHg | | |[[Pulmonary embolism Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal | | |[[widget:PE_calculator]] |
| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |>45 mmHg | | |[[Pulmonary embolism modified Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" + |High | | |[[Widget:PE Modified Wells score calculator]] |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" + |Venous | | |[[AMUSE score calculator]] |
| | align="left" style="background:#F5F5F5;" + |40 to 45 mmHg | | |[[Widget:AMUSE_score_calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal
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| |- | | |- |
| ! rowspan="4" align="center" style="background:#DCDCDC;" + |Bicarbonate (HCO<sub><big>3</big></sub><sup>−</sup>)
| | |[[HAMILTON score calculator]] |
| | rowspan="3" align="center" style="background:#DCDCDC;" + |Arterial
| | |[[Widget:HAMILTON_score_calculator]] |
| | align="left" style="background:#F5F5F5;" + |<22 mmol/L | |
| | align="left" style="background:#F5F5F5;" + |Low
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| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |22 to 26 mmol/L | | |[[Geneva score calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal | | |[[Widget:Geneva_score_calculator]] |
| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |>26 mmol/L | | |[[Revised Geneva score calculator]] |
| | align="left" style="background:#F5F5F5;" + |High | | |[[Widget:Revised_Geneva_score_calculator]] |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" + |Venous | | |[[Simplified Geneva Score calculator]] |
| | align="left" style="background:#F5F5F5;" + |19 to 28 mmol/L | | |[[Widget:Simplified_Geneva_score_calculator]] |
| | align="left" style="background:#F5F5F5;" + |Normal
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| |- | | |- |
| ! rowspan="4" align="center" style="background:#DCDCDC;" + |Base Excess (BE)
| | |[[TIMI Risk Score for Unstable Angina or NSTEMI]] |
| | rowspan="3" align="center" style="background:#DCDCDC;" + |Arterial
| | |[[Widget:TIMI_UA_NSTEMI]] |
| | align="left" style="background:#F5F5F5;" + |<−3.4 | |
| | align="left" style="background:#F5F5F5;" + |Acidemia
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| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |−3.4 to +2.3 mmol/L | | |[[TIMI Risk Score for STEMI]] |
| | align="left" style="background:#F5F5F5;" + |Normal | | |[[Widget:TIMI_STEMI]] |
| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |>2.3 | | |[[Tygerberg score]] |
| | align="left" style="background:#F5F5F5;" + |Alkalemia | | |[[widget:Tygerberg_score]] |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" + |Venous | | |[[CHA2DS2-VASc Score]] |
| | align="left" style="background:#F5F5F5;" + |−2 to −5 mmol/L | | |[[Widget:CHA2DS2VASc]] |
| | align="left" style="background:#F5F5F5;" + |Normal
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| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Osmolar gap = Osmolality – Osmolarity
| | |[[CHADS2 score]] |
| | align="left" style="background:#F5F5F5;" + |>10
| | |[[Widget:CHADS2score]] |
| | align="left" style="background:#F5F5F5;" + |Abnormal | |
| |- | | |- |
| ! colspan="2" rowspan="3" align="center" style="background:#DCDCDC;" + |Anion gap = [Na<sup>+</sup>] – {[Cl<sup>−</sup>]+[HCO<sub><big>3</big></sub><sup>−</sup>]}
| | |[[HAS-BLED score]] |
| Corrected AG = (measured serum AG) + (2.5 x [4.5 − Alb])
| | |[[Widget:HASBLEDscore]] |
| | align="left" style="background:#F5F5F5;" + |<8
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| | align="left" style="background:#F5F5F5;" + |Low
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| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |8 to 16 | | |[[The GRACE risk score]] |
| | align="left" style="background:#F5F5F5;" + |Normal | | |[[Widget:GRACEscore]] |
| |- | | |- |
| | align="left" style="background:#F5F5F5;" + |>16
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| | align="left" style="background:#F5F5F5;" + |High
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| |}
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| == Compensation ==
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| * There are compensation mechanisms in the body in order to normalizing the pH inside the blood.<ref name="pmid20859488">{{cite journal |vauthors=Sood P, Paul G, Puri S |title=Interpretation of arterial blood gas |journal=Indian J Crit Care Med |volume=14 |issue=2 |pages=57–64 |date=April 2010 |pmid=20859488 |pmc=2936733 |doi=10.4103/0972-5229.68215 |url=}}</ref>
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| * The amount of compensation depends on proper functioning of renal and respiratory systems. However, it is uncommon to compensate completely. Compensatory mechanisms might correct only 50–75% of pH to normal.
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| * Acute respiratory compensation usually occurs within first day. However, chronic respiratory compensation takes 1 to 4 days to occur.
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| * Renal compensation might occur slower than respiratory compensation.
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| {|
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Primary disorder
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |pH
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |PaCO<sub>2</sub>
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |[HCO3<sup>−</sup>]
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Compensation
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Compensation formula
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| |-
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| ! align="center" style="background:#DCDCDC;" + |[[Metabolic acidosis]]
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| | align="center" style="background:#F5F5F5;" + |↓
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| | align="center" style="background:#F5F5F5;" + |↓
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| | align="center" style="background:#F5F5F5;" + |↓
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| | align="left" style="background:#F5F5F5;" + |Respiratory
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| | align="left" style="background:#F5F5F5;" + |
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| * Expected paCO<sub>2</sub> = 1.5 x serum HCO<sub><big>3</big></sub><sup>−</sup> + 8 ± 2 ([[Winters' formula]])
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| * Expected paCO<sub>2</sub> = Serum HCO<sub><big>3</big></sub><sup>−</sup> + 15
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| |-
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| ! align="center" style="background:#DCDCDC;" + |[[Metabolic alkalosis]]
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| | align="center" style="background:#F5F5F5;" + |↑
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| | align="center" style="background:#F5F5F5;" + |↑
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| | align="center" style="background:#F5F5F5;" + |↑
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| | align="left" style="background:#F5F5F5;" + |Respiratory
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| | align="left" style="background:#F5F5F5;" + |
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| * Expected paCO<sub>2</sub> = 0.5 − 1 increase/ every 1 unit increase in serum HCO<sub><big>3</big></sub><sup>−</sup> from 24
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| |-
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| ! align="center" style="background:#DCDCDC;" + |[[Respiratory acidosis]]
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| | align="center" style="background:#F5F5F5;" + |↓
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| | align="center" style="background:#F5F5F5;" + |↑
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| | align="center" style="background:#F5F5F5;" + |↑
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| | align="left" style="background:#F5F5F5;" + |Renal
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| | align="left" style="background:#F5F5F5;" + |
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| * Acute: HCO<sub><big>3</big></sub><sup>−</sup> increases by 1mEq/L for every 10 mmHg increase in paCO2 above 40
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| * Chronic: HCO<sub><big>3</big></sub><sup>−</sup> increases by 3.5mEq/L for every 10 mmHg increase in paCO2 above 40
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| |-
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| ! align="center" style="background:#DCDCDC;" + |[[Respiratory alkalosis]]
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| | align="center" style="background:#F5F5F5;" + |↑
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| | align="center" style="background:#F5F5F5;" + |↓
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| | align="center" style="background:#F5F5F5;" + |↓
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| | align="left" style="background:#F5F5F5;" + |Renal
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| | align="left" style="background:#F5F5F5;" + |
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| * Acute: HCO<sub><big>3</big></sub><sup>−</sup> decreases by 2mEq/L for every 10 mmHg derease in paCO2 above 40
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| * Chronic: HCO<sub><big>3</big></sub><sup>−</sup> decreases by 5mEq/L for every 10 mmHg decrease in paCO2 above 40
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| |}
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|
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| ==Approach to acid–base disorders==
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| {{familytree/start |summary=Sample 1}}
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| {{familytree | | | | | | | | A01 |A01=Check [[pH]] on ABG}}
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| {{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }}
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| {{familytree | | | B01 | | | | | | | |B02| | |B01=pH < 7.35= '''[[Acidosis]]'''|B02=pH > 7.45= '''[[Alkalosis]]'''}}
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| {{familytree | | | |!| | | | | | | | | |!| }}
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| {{familytree | | | C01 | | | | | | | | |!| |C01=Check PaCO<sub>2</sub>}}
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| {{familytree | |,|-|^|.| | | | | | | | |!| }}
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| {{familytree | D01 | | D02 | | | | | | D03 |D01=PaCO<sub>2</sub> > 45mm Hg = <br>'''[[Respiratory acidosis]]'''|D02=PaCO<sub>2</sub> Normal or < 35mm Hg = <br>'''[[Metabolic acidosis]]'''|D03=Check PaCO<sub>2</sub>}}
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| {{familytree | | | | | | | | | | | |,|-|^|.| }}
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| {{familytree | | | | | | | | | | |E02| | E03 | |E02=PaCO<sub>2</sub> > 45mm Hg = <br>'''[[Metabolic alkalosis]]'''|E03=PaCO<sub>2</sub> < 35mm Hg = <br>'''[[Respiratory alkalosis]]'''}}
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| {{familytree | | | | | | | | | | |!| | | | |!| }}
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| {{familytree | | | | | | | | | | F01 | | | F02 |F01=[HCO<sub>3</sub><sup>-</sup>] > 29|F02=Check [HCO<sub>3</sub><sup>-</sup>]}}
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| {{Familytree | | | | | | | | | | | | |,|-|-|^|-|-|.| | }}
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| {{Familytree | | | | | | | | | | | |C01 | | | | C02 |C01= Normal or slight decrease = <br>'''Acute [[respiratory alkalosis]]'''| C02= Decreased < 24 = <br>'''Chronic [[respiratory alkalosis]]'''}}
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| {{familytree/end}}
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|
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| ==Management of Acidosis==
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| {{familytree/start}}
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| {{familytree | | | | | | | | | A01 | | | | | |A01=[[pH]] < 7.35}}
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| {{familytree | | | | | | | | | |!| | | | | | | | }}
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| {{familytree | | | | | | | | | B01 | | | | | |B01=[[Acidosis]]}}
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| {{familytree | | | | | | | | | |!| | | | | | | | }}
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| {{familytree | | | | | | | | | B02 | | | | | |B02='''Determine the primary disorder'''<br> Metabolic or respiratory?}}
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| {{familytree | | | | | | | | | |!| | | | | | | | }}
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| {{familytree | | | | | | | | | B03 | | | | | |B03=Check [HCO3<sup>-</sup>] and PaCO<sub>2</sub>}}
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| {{familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|-|-|.| }}
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| {{familytree | | | C01 | | | | | | | | | | | |C02|C01=Low [HCO3<sup>-</sup>] <br>and<br> Low to normal PaCO<sub>2</sub>|C02= High PaCO<sub>2</sub> <br>and<br> High to normal [HCO3<sup>-</sup>] }}
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| {{familytree | | | |!| | | | | | | | | | | | | |!| }}
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| {{familytree | | | C03 | | | | | | | | | | | | C04 |C03=[[Metabolic acidosis]]|C04=[[Respiratory acidosis]]}}
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| {{familytree | | | |!| | | | | | | | | | | | | |!| }}
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| {{familytree | | | C05 | | | | | | | | | | | | C06 |C05='''Check for respiratory compensation'''<br><br>Calculate expected PCO<sub>2</sub>|C06='''Check for renal compensation'''<br><br> Calculate expected [HCO3<sup>-</sup>] }}
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| {{familytree | | | |!| | | | | | | | | | | | | |!| }}
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| {{familytree | | | |!| | | | | | | | | |,|-|-|-|^|-|-|-|-|.|}}
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| {{familytree | | | D01 | | | | | | | | D02 | | | | | | D03 |D01=Decrease in PaCO<sub>2</sub>=1.25 x (24- measured HCO3<sup>-</sup>)?|D02='''Acute acidosis?'''<br><br>Increase [HCO3<sup>-</sup>]=0.1 x (measure PaCO<sub>2</sub>-40)?|D03='''Chronic acidosis?'''<br><br>Increase [HCO3<sup>-</sup>]=0.1 x (measure PaCO<sub>2</sub>-40)?}}
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| {{familytree | |,|-|+|-|.| | | | | |,|-|+|-|.| | | |,|-|+|-|.| | }}
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| {{familytree | E01 |!| E02 | | | | E03 |!| E04 | | E05 |!| E06 |E01=PaCO<sub>2</sub> too low?<br><br> '''Mixed metabolic acidosis with respiratory alkalosis'''|E02=PaCO<sub>2</sub> too high?<br><br> '''Mixed metabolic acidosis with respiratory acidosis'''|E03=[HCO3<sup>-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E04=[HCO3<sup>-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis'''|E05=[HCO3<sup>-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E06=E04=[HCO3<sup>-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis''' }}
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| {{familytree | |:| E07 |:| | | | | |:| E08 |:| | | |:| E09 |:|E07=Measured PaCO<sub>2</sub> is equal to expected value?<br><br> '''Compensated metabolic acidosis'''|E08=Measured [HCO3<sup>-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis'''|E09=Measured [HCO3<sup>-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis''' }}
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| {{familytree | |:| |:| |:| | | | | |:| |:| |:| | | |:| |:| |:| | }}
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| {{familytree | |L| F01 |J| | | | | |L|~|A|~|A| F02 |A|~|A|~|J| | F01=[[Metabolic acidosis resident survival guide|'''Click here for the management of metabolic acidosis''']]|F02=[[Respiratory acidosis resident survival guide|'''Click here for the management of respiratory acidosis''']] }}
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| {{familytree/end}}
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|
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| ==Metabolic Acidosis==
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| '''''Differential diagnosis of metabolic acidosis is as follow:'''''<ref name="pmid17936961">{{cite journal |vauthors=Lim S |title=Metabolic acidosis |journal=Acta Med Indones |volume=39 |issue=3 |pages=145–50 |date=2007 |pmid=17936961 |doi= |url=}}</ref><ref name="MorrisLow2008">{{cite journal|last1=Morris|first1=C. G.|last2=Low|first2=J.|title=Metabolic acidosis in the critically ill: Part 1. Classification and pathophysiology|journal=Anaesthesia|volume=63|issue=3|year=2008|pages=294–301|issn=00032409|doi=10.1111/j.1365-2044.2007.05370.x}}</ref><ref name="pmid18336491">{{cite journal |vauthors=Morris CG, Low J |title=Metabolic acidosis in the critically ill: part 2. Causes and treatment |journal=Anaesthesia |volume=63 |issue=4 |pages=396–411 |date=April 2008 |pmid=18336491 |doi=10.1111/j.1365-2044.2007.05371.x |url=}}</ref><ref name="Casaletto2005">{{cite journal|last1=Casaletto|first1=Jennifer J.|title=Differential Diagnosis of Metabolic Acidosis|journal=Emergency Medicine Clinics of North America|volume=23|issue=3|year=2005|pages=771–787|issn=07338627|doi=10.1016/j.emc.2005.03.007}}</ref>
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| {|
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| ! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
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| ! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
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| ! colspan="3" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Mechanism
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| ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical
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| ! colspan="18" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical
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| ! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
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| ! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
| |
| |-
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| ! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms
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| ! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs
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| ! colspan="18" align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab data
| |
| |-
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| ! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |ABG
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| ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
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| ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Chemistry
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| ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal
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| ! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |U/A
| |
| |-
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↑ acid <br>production
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Loss of <br>bicarbonate
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ renal acid <br>excretion
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Diarrhea
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |LOC
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |WBC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hb
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BS
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketones
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lactic acid
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum AG<ref>Brubaker RH, Meseeha M. High Anion Gap Metabolic Acidosis. [Updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448090/</ref>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Osmolar gap<ref name="pmid217949663">{{cite journal |vauthors=Kraut JA, Xing SX |title=Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion-gap metabolic acidosis |journal=Am. J. Kidney Dis. |volume=58 |issue=3 |pages=480–4 |date=September 2011 |pmid=21794966 |doi=10.1053/j.ajkd.2011.05.018 |url=}}</ref>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine pH
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine ketone
| |
| |-
| |
| ! rowspan="10" align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxin/Medication<ref name="PhamXu2015">{{cite journal|last1=Pham|first1=Amy Quynh Trang|last2=Xu|first2=Li Hao Richie|last3=Moe|first3=Orson W.|title=Drug-Induced Metabolic Acidosis|journal=F1000Research|year=2015|issn=2046-1402|doi=10.12688/f1000research.7006.1}}</ref>
| |
| ! rowspan="2" align="center" style="background:#DCDCDC;" + |Alcohol<ref name="pmid15902789">{{cite journal |vauthors=Zehtabchi S, Sinert R, Baron BJ, Paladino L, Yadav K |title=Does ethanol explain the acidosis commonly seen in ethanol-intoxicated patients? |journal=Clin Toxicol (Phila) |volume=43 |issue=3 |pages=161–6 |date=2005 |pmid=15902789 |doi= |url=}}</ref><ref name="RobertsYates2015">{{cite journal|last1=Roberts|first1=Darren M.|last2=Yates|first2=Christopher|last3=Megarbane|first3=Bruno|last4=Winchester|first4=James F.|last5=Maclaren|first5=Robert|last6=Gosselin|first6=Sophie|last7=Nolin|first7=Thomas D.|last8=Lavergne|first8=Valéry|last9=Hoffman|first9=Robert S.|last10=Ghannoum|first10=Marc|title=Recommendations for the Role of Extracorporeal Treatments in the Management of Acute Methanol Poisoning|journal=Critical Care Medicine|volume=43|issue=2|year=2015|pages=461–472|issn=0090-3493|doi=10.1097/CCM.0000000000000708}}</ref>
| |
| ! align="left" style="background:#DCDCDC;" + |
| |
| * Methanol
| |
| * Ethylene glycol
| |
| * Propylene glycol
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |↓ ↑
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |Nl or ↑
| |
| | align="center" style="background:#F5F5F5;" + |Nl or ↑
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="left" style="background:#F5F5F5;" + |Clinical
| |
| | align="left" style="background:#F5F5F5;" + |
| |
| * Positive oxalate crystals in urine
| |
| |-
| |
| ! align="left" style="background:#DCDCDC;" + |
| |
| * Isopropyl alcohol<ref>Ashurst JV, Nappe TM. Toxicity, Isopropanol. [Updated 2018 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493181/</ref>
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + |−
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |↑
| |
| | align="center" style="background:#F5F5F5;" + |Nl
| |
| | align="center" style="background:#F5F5F5;" + |Nl or ↑
| |
| | align="center" style="background:#F5F5F5;" + |↓
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="center" style="background:#F5F5F5;" + | +
| |
| | align="left" style="background:#F5F5F5;" + |Clinical
| |
| | align="left" style="background:#F5F5F5;" + |
| |
| |-
| |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Toluene<ref name="Camara-LemarroyRodríguez-Gutiérrez2015">{{cite journal|last1=Camara-Lemarroy|first1=Carlos Rodrigo|last2=Rodríguez-Gutiérrez|first2=René|last3=Monreal-Robles|first3=Roberto|last4=González-González|first4=José Gerardo|title=Acute toluene intoxication–clinical presentation, management and prognosis: a prospective observational study|journal=BMC Emergency Medicine|volume=15|issue=1|year=2015|issn=1471-227X|doi=10.1186/s12873-015-0039-0}}</ref>
| |
| | +
| |
| | −
| |
| | +
| |
| | −
| |
| |<nowiki>+</nowiki>
| |
| |−
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |↓
| |
| | −
| |
| |↓
| |
| |↓↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↓
| |
| |Nl
| |
| |−
| |
| |↑
| |
| |Nl or ↑
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |↓
| |
| | −
| |
| |<nowiki>+</nowiki>
| |
| |Clinical
| |
| | | | | |
| * Most widely abused inhaled drugs
| |
| |-
| |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Salicylates<ref name="WrightSop2015">{{cite journal|last1=Wright|first1=Dallas|last2=Sop|first2=Jessica|title=Normal anion gap salicylate poisoning|journal=The American Journal of Emergency Medicine|volume=33|issue=11|year=2015|pages=1714.e3–1714.e4|issn=07356757|doi=10.1016/j.ajem.2015.03.042}}</ref>
| |
| | +
| |
| | −
| |
| |−
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓
| |
| | +
| |
| |↓
| |
| |↓
| |
| |↓↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl to ↓
| |
| |Nl
| |
| |↓
| |
| |Nl
| |
| |−
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↓
| |
| | −
| |
| |−
| |
| |Clinical and elevated serum salicylate
| |
| | | | | |
| * Paradoxical alkalosis
| |
| * Elevated serum salicylate
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Metformin<ref name="GalieroConsani2018">{{cite journal|last1=Galiero|first1=Francesca|last2=Consani|first2=Giovanni|last3=Biancofiore|first3=Gianni|last4=Ruschi|first4=Stefano|last5=Forfori|first5=Francesco|title=Metformin intoxication: Vasopressin's key role in the management of severe lactic acidosis|journal=The American Journal of Emergency Medicine|volume=36|issue=2|year=2018|pages=341.e5–341.e6|issn=07356757|doi=10.1016/j.ajem.2017.10.057}}</ref>
| | |[[Ranson criteria]] |
| | +
| | [[Acute pancreatitis diagnostic criteria]] |
| | − | | |[[Widget:RansonScore]] |
| | −
| |
| | −
| |
| | +
| |
| | −
| |
| | −
| |
| | +
| |
| |↓
| |
| |±
| |
| |Agitated
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl to ↑
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Nl or ↑
| |
| |Nl
| |
| |↓
| |
| | −
| |
| | −
| |
| |Clinical
| |
| |
| |
| * Liver failure
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Isoniazid<ref name="pmid2304098">{{cite journal |vauthors=Watkins RC, Hambrick EL, Benjamin G, Chavda SN |title=Isoniazid toxicity presenting as seizures and metabolic acidosis |journal=J Natl Med Assoc |volume=82 |issue=1 |pages=57, 62, 64 |date=January 1990 |pmid=2304098 |pmc=2625939 |doi= |url=}}</ref>
| | |[[Apgar score]] |
| | + | | |[[Widget:Apgarscore]] |
| |−
| |
| |−
| |
| |−
| |
| | +
| |
| |−
| |
| |−
| |
| | +
| |
| |↑
| |
| | +
| |
| |Agitated
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |Nl or ↑
| |
| |Nl
| |
| |↓
| |
| |−
| |
| |−
| |
| |Clinical
| |
| |
| |
| * Seizure
| |
| * Ataxia
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Acetazolamide<ref name="TeppemaBalanos2007">{{cite journal|last1=Teppema|first1=Luc J.|last2=Balanos|first2=George M.|last3=Steinback|first3=Craig D.|last4=Brown|first4=Allison D.|last5=Foster|first5=Glen E.|last6=Duff|first6=Henry J.|last7=Leigh|first7=Richard|last8=Poulin|first8=Marc J.|title=Effects of Acetazolamide on Ventilatory, Cerebrovascular, and Pulmonary Vascular Responses to Hypoxia|journal=American Journal of Respiratory and Critical Care Medicine|volume=175|issue=3|year=2007|pages=277–281|issn=1073-449X|doi=10.1164/rccm.200608-1199OC}}</ref>
| | |[[Glasgow coma scale]] |
| | -
| | |[[Widget:Adult_GCS]] |
| | +
| |
| | -
| |
| | -
| |
| | -
| |
| | -
| |
| | -
| |
| | -
| |
| |↓
| |
| | +
| |
| |Nl
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl or ↑
| |
| |Nl
| |
| |↓
| |
| |−
| |
| |−
| |
| |Clinical
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Amphotericin B<ref name="BatesSu2001">{{cite journal|last1=Bates|first1=D. W.|last2=Su|first2=L.|last3=Yu|first3=D. T.|last4=Chertow|first4=G. M.|last5=Seger|first5=D. L.|last6=Gomes|first6=D. R. J.|last7=Dasbach|first7=E. J.|last8=Platt|first8=R.|title=Mortality and Costs of Acute Renal Failure Associated with Amphotericin B Therapy|journal=Clinical Infectious Diseases|volume=32|issue=5|year=2001|pages=686–693|issn=1058-4838|doi=10.1086/319211}}</ref>
| | |[[Pediatric Glasgow Coma Scale]] |
| | -
| | |[[Widget:PGCS]] |
| | -
| |
| | +
| |
| | -
| |
| | +
| |
| | +
| |
| | -
| |
| | +
| |
| |↓
| |
| | +
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |↓
| |
| | -
| |
| | -
| |
| |Clinical
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |CO<ref name="pmid10333448">{{cite journal |vauthors=Piantadosi CA |title=Diagnosis and treatment of carbon monoxide poisoning |journal=Respir Care Clin N Am |volume=5 |issue=2 |pages=183–202 |date=June 1999 |pmid=10333448 |doi= |url=}}</ref>
| | |[[Cincinnati stroke scale]] |
| | +
| | |[[Widget:Cincinnati_Stroke_Scale]] |
| |<nowiki>-</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |±
| |
| | -
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |Nl
| |
| | -
| |
| |↓↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↓
| |
| |−
| |
| |−
| |
| |Clinical
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Cyanide<ref name="pmid12352039">{{cite journal |vauthors=Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, Vicaut E, Debray M, Bismuth C |title=Value of lactic acidosis in the assessment of the severity of acute cyanide poisoning |journal=Crit. Care Med. |volume=30 |issue=9 |pages=2044–50 |date=September 2002 |pmid=12352039 |doi=10.1097/01.CCM.0000026325.65944.7D |url=}}</ref>
| | |[[DIPSS Plus Score]] |
| | +
| | |[[Widget:DIPSS_Plus_Score]] |
| |−
| |
| |−
| |
| | -
| |
| | +
| |
| |−
| |
| |−
| |
| | +
| |
| |↓
| |
| |±
| |
| |↓↓
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↑
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |Nl or ↑
| |
| |Nl
| |
| |↓
| |
| |−
| |
| |−
| |
| |Blood cyanide concentration
| |
| | | |
| |- | | |- |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
| | | colspan="2" |[[ICU scoring systems]] |
| ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↑ acid <br>production
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Loss of <br>bicarbonate
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ renal acid <br>excretion
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Diarrhea
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |LOC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |WBC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hb
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BS
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketones
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lactic acid
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Osmolar gap
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine pH
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine ketone
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
| |
| |- | | |- |
| | rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketoacidosis | | |[[APACHE II]] |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Diabetic<ref name="WolfsdorfAllgrove2014">{{cite journal|last1=Wolfsdorf|first1=Joseph I|last2=Allgrove|first2=Jeremy|last3=Craig|first3=Maria E|last4=Edge|first4=Julie|last5=Glaser|first5=Nicole|last6=Jain|first6=Vandana|last7=Lee|first7=Warren WR|last8=Mungai|first8=Lucy NW|last9=Rosenbloom|first9=Arlan L|last10=Sperling|first10=Mark A|last11=Hanas|first11=Ragnar|title=Diabetic ketoacidosis and hyperglycemic hyperosmolar state|journal=Pediatric Diabetes|volume=15|issue=S20|year=2014|pages=154–179|issn=1399543X|doi=10.1111/pedi.12165}}</ref>
| | |[[Widget:APACHEII]] |
| | +
| |
| | −
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓
| |
| | +
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |↑
| |
| |Nl to ↑
| |
| |↑↑
| |
| |Nl
| |
| |↓
| |
| |↓
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Nl to ↑
| |
| |Nl
| |
| |↓
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |Clinical + hyperglycemia + ketosis
| |
| |
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Starvation<ref name="pmid27752032">{{cite journal |vauthors=Mostert M, Bonavia A |title=Starvation Ketoacidosis as a Cause of Unexplained Metabolic Acidosis in the Perioperative Period |journal=Am J Case Rep |volume=17 |issue= |pages=755–758 |date=October 2016 |pmid=27752032 |pmc=5070574 |doi= |url=}}</ref>
| | |[[SAPS II]] |
| | +
| | |[[Widget:SAPSII]] |
| | −
| |
| | −
| |
| | −
| |
| | +
| |
| | −
| |
| | −
| |
| | +
| |
| |↓
| |
| | +
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl to ↓
| |
| |Nl
| |
| |↓
| |
| |↓
| |
| |↑
| |
| |Nl
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| | +
| |
| | −
| |
| |Clinical
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Alcoholic (Ethanol)<ref name="pmid28613672">{{cite journal |vauthors=Howard RD, Bokhari SRA |title= |journal= |volume= |issue= |pages= |date= |pmid=28613672 |doi= |url=}}</ref>
| | |[[SAPS III]] |
| | + | | |[[Widget:SAPSIII]] |
| |−
| |
| |−
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |±
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |↓ ↑
| |
| | +
| |
| |Agitated
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↑
| |
| |Nl to ↑
| |
| |↓ Nl ↑
| |
| |Nl
| |
| |↓
| |
| |↓
| |
| |↑↑
| |
| |↑
| |
| |↑
| |
| |↑↑
| |
| |↑
| |
| |Nl
| |
| |↓
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |Clinical + ketosis
| |
| |
| |
| * Chronic alcohol abuse
| |
| * Zero or low alcohol level
| |
| |- | | |- |
| | rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | | |[[PIM2]] |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Sepsis<ref name="pmid28149822">{{cite journal |vauthors=Ganesh K, Sharma RN, Varghese J, Pillai MG |title=A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting |journal=Int J Crit Illn Inj Sci |volume=6 |issue=4 |pages=178–181 |date=2016 |pmid=28149822 |pmc=5225760 |doi=10.4103/2229-5151.195417 |url=}}</ref>
| |
| | +
| |
| | −
| |
| |−
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓ ↑
| |
| | +
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↓
| |
| |Nl
| |
| |Nl to ↑
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| | −
| |
| |−
| |
| |Clinical and lab finding
| |
| | | | | |
| | |} |
| | ==Table== |
| | {| |
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Complications |
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Polymyositis |
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dermatomyositis |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Ischemia<ref name="KimmounNovy2015">{{cite journal|last1=Kimmoun|first1=Antoine|last2=Novy|first2=Emmanuel|last3=Auchet|first3=Thomas|last4=Ducrocq|first4=Nicolas|last5=Levy|first5=Bruno|title=Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside|journal=Critical Care|volume=19|issue=1|year=2015|issn=1364-8535|doi=10.1186/s13054-015-0896-7}}</ref> | | ! align="center" style="background:#DCDCDC;" + |[[Cancer|Malignancy]] |
| | + | | | align="left" style="background:#F5F5F5;" + | |
| | −
| | *[[Lung]] |
| |−
| | | align="left" style="background:#F5F5F5;" + | |
| |−
| | *[[Lung]] |
| |<nowiki>+</nowiki>
| | |} |
| |−
| | <br> |
| |<nowiki>+</nowiki>
| | ===Calculation of the Padua Prediction Score=== |
| |<nowiki>+</nowiki>
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
| |↓
| | |
| | +
| | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| | −
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| |↓
| |
| |↓ ↑
| |
| |Nl to ↓
| |
| |Nl to ↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↓
| |
| |Nl
| |
| |Nl to ↑
| |
| |Nl
| |
| |Nl
| |
| |Nl to ↑
| |
| |Nl to ↑
| |
| |Nl
| |
| | −
| |
| |−
| |
| |Clinical and lab finding
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Lactic acidosis<ref name="KrautIngelfinger2014">{{cite journal|last1=Kraut|first1=Jeffrey A.|last2=Ingelfinger|first2=Julie R.|last3=Madias|first3=Nicolaos E.|title=Lactic Acidosis|journal=New England Journal of Medicine|volume=371|issue=24|year=2014|pages=2309–2319|issn=0028-4793|doi=10.1056/NEJMra1309483}}</ref> | | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| | +
| | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| | −
| |
| | −
| |
| |±
| |
| | +
| |
| | −
| |
| | −
| |
| | +
| |
| |↓ ↑
| |
| |±
| |
| |Agitated
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↑
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Nl or ↑
| |
| |Nl
| |
| |↓
| |
| | −
| |
| | −
| |
| |Clinical and lab finding
| |
| | | |
| |- | | |- |
| | rowspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active gastric or duodenal ulcer |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Uremia<ref name="BrownMelamed2018">{{cite journal|last1=Brown|first1=Denver|last2=Melamed|first2=Michal L.|title=New Frontiers in Treating Uremic Metabolic Acidosis|journal=Clinical Journal of the American Society of Nephrology|volume=13|issue=1|year=2018|pages=4–5|issn=1555-9041|doi=10.2215/CJN.11771017}}</ref>
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4.5 |
| | −
| |
| | −
| |
| | +
| |
| | +
| |
| | +
| |
| | −
| |
| | −
| |
| | +
| |
| |↓ ↑
| |
| |±
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |↑
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↓
| |
| | +
| |
| | −
| |
| |Clinical and lab finding
| |
| |
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Ureteral diversion | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Prior bleeding within the last 3 months |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | +
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |Nl
| |
| |Nl
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Renal failure<ref name="KrautMadias2016">{{cite journal|last1=Kraut|first1=Jeffrey A.|last2=Madias|first2=Nicolaos E.|title=Metabolic Acidosis of CKD: An Update|journal=American Journal of Kidney Diseases|volume=67|issue=2|year=2016|pages=307–317|issn=02726386|doi=10.1053/j.ajkd.2015.08.028}}</ref> | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Thrombocytopenia (<50x10<sup>9</sup>/L) |
| | −
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | −
| |
| | +
| |
| | −
| |
| | +
| |
| | −
| |
| | −
| |
| | +
| |
| |↓
| |
| | +
| |
| |↓
| |
| |↓
| |
| |↓
| |
| |Nl to ↓
| |
| |
| |
| |
| |
| |
| |
| |↑
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |↑
| |
| |↑
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| | | |
| |- | | |- |
| ! rowspan="3" align="center" style="background:#DCDCDC;" + |Renal tubular acidosis<ref name="Gil-PeñaMejía2014">{{cite journal|last1=Gil-Peña|first1=Helena|last2=Mejía|first2=Natalia|last3=Santos|first3=Fernando|title=Renal Tubular Acidosis|journal=The Journal of Pediatrics|volume=164|issue=4|year=2014|pages=691–698.e1|issn=00223476|doi=10.1016/j.jpeds.2013.10.085}}</ref> | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age ≥ 85 years |
| ! align="center" style="background:#DCDCDC;" + |Type I<ref name="Hemstreet2004">{{cite journal|last1=Hemstreet|first1=Brian A|title=Antimicrobial-Associated Renal Tubular Acidosis|journal=Annals of Pharmacotherapy|volume=38|issue=6|year=2004|pages=1031–1038|issn=1060-0280|doi=10.1345/aph.1D573}}</ref>
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |3.5 |
| | − | |
| | −
| |
| | +
| |
| |±
| |
| |±
| |
| | −
| |
| | −
| |
| | −
| |
| |↓ ↑
| |
| | −
| |
| | −
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |↑
| |
| | +
| |
| | −
| |
| |Clinical and lab finding
| |
| |
| |
| * Associated with autoimmune diseases
| |
| * Growth retardation in children
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" + |Type II | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Liver failure (INR>1.5) |
| | −
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| | +
| |
| | −
| |
| |±
| |
| |±
| |
| | −
| |
| | −
| |
| | −
| |
| |↓ ↑
| |
| | −
| |
| | −
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| | −
| |
| | −
| |
| |Clinical and lab finding
| |
| | | |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" + |Type IV | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Severe kidney failure (GFR< 30 mL/min/m<sup>2</sup>) |
| | −
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| | −
| |
| | +
| |
| |±
| |
| |±
| |
| |±
| |
| | −
| |
| | −
| |
| |↓
| |
| | −
| |
| | −
| |
| |↓
| |
| |↓
| |
| |Nl | |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| | +
| |
| | −
| |
| |Clinical and lab finding
| |
| |
| |
| * Hypoaldosteronism
| |
| |- | | |- |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Admission to ICU or CCU |
| ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↑ acid <br>production
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Loss of <br>bicarbonate
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ renal acid <br>excretion
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Diarrhea
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |LOC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |WBC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hb
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BS
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketones
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lactic acid
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Osmolar gap
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine pH
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine ketone
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
| |
| |- | | |- |
| | rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Heart
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Central venous catheter |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Heart failure<ref name="ParkChoi2015">{{cite journal|last1=Park|first1=Jin Joo|last2=Choi|first2=Dong-Ju|last3=Yoon|first3=Chang-Hwan|last4=Oh|first4=Il-Young|last5=Lee|first5=Ju Hyun|last6=Ahn|first6=Soyeon|last7=Yoo|first7=Byung-Su|last8=Kang|first8=Seok-Min|last9=Kim|first9=Jae-Joong|last10=Baek|first10=Sang-Hong|last11=Cho|first11=Myeong-Chan|last12=Jeon|first12=Eun-Seok|last13=Chae|first13=Shung Chull|last14=Ryu|first14=Kyu-Hyung|last15=Oh|first15=Byung-Hee|title=The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry|journal=European Journal of Heart Failure|volume=17|issue=6|year=2015|pages=601–611|issn=13889842|doi=10.1002/ejhf.276}}</ref>
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| | +
| |
| | +
| |
| | −
| |
| | −
| |
| |±
| |
| | −
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓ ↑
| |
| | +
| |
| |−
| |
| |↓
| |
| |↓ ↑
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl to ↑
| |
| |Nl to ↑
| |
| |Nl
| |
| | −
| |
| |−
| |
| |Clinical and echocardiogram
| |
| |
| |
| * Hypoalbuminemia
| |
| * Elevated serum natriuretic peptide
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |MI<ref name="MannBajulaiye2014">{{cite journal|last1=Mann|first1=Sarah|last2=Bajulaiye|first2=Akinyemi|last3=Sturgeon|first3=Kathleen|last4=Sabri|first4=Abdelkarim|last5=Muthukumaran|first5=Geetha|last6=Libonati|first6=Joseph R.|title=Effects of acute angiotensin II on ischemia reperfusion injury following myocardial infarction|journal=Journal of the Renin-Angiotensin-Aldosterone System|volume=16|issue=1|year=2014|pages=13–22|issn=1470-3203|doi=10.1177/1470320314554963}}</ref> | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Rheumatic disease |
| | +
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| | −
| |
| |−
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓ ↑
| |
| | −
| |
| |↓
| |
| |↓
| |
| |↓ ↑
| |
| |Nl to ↓
| |
| |Nl to ↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |↓
| |
| |Nl
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl to ↑
| |
| |Nl to ↑
| |
| |Nl
| |
| | −
| |
| |−
| |
| |Clinical and ECG
| |
| | | |
| |- | | |- |
| ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |GI | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active malignancy |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Diarrhea
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| | −
| |
| | +
| |
| | −
| |
| |±
| |
| | +
| |
| | +
| |
| |−
| |
| | +
| |
| |↓
| |
| | +
| |
| |−
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |↓
| |
| |↓
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |−
| |
| |−
| |
| |
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Hyperalimentation | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age: 40-84 years |
| | +
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1.5 |
| | +
| |
| |−
| |
| |−
| |
| |−
| |
| | +
| |
| |−
| |
| |−
| |
| |Nl
| |
| |−
| |
| |−
| |
| |↓
| |
| |↓
| |
| |Nl
| |
| |Nl
| |
| |↓
| |
| |↓ ↑
| |
| |↑
| |
| |↑
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |Nl
| |
| |−
| |
| |−
| |
| |Clinical
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Liver failure | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |Nl
| |
| |Nl
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| | | |
| |- | | |- |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Moderate kidney failure (GFR: 30-59 mL/min/m<sup>2</sup>) |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Hyperparathyroidism
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| |
| |
| | +
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |Nl
| |
| |Nl
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| | | |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" + |Addison's disease | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |Nl
| |
| |Nl
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| | | |
| |- | | |- |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
| | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↑ acid <br>production
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Loss of <br>bicarbonate
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ renal acid <br>excretion
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Diarrhea
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |LOC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |WBC
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hb
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |BS
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup>
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketones
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lactic acid
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Osmolar gap
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine pH
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine AG
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine ketone
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings
| |
| |} | | |} |
| | <br style="clear:left" /> |
|
| |
|
| == Metabolic Alkalosis == | | ===Calculation of the test Prediction Score=== |
| '''''Differential diagnosis of metabolic alkalosis is as follow''''':
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
| {| class="wikitable" | | |
| ! rowspan="4" |Category
| | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| ! rowspan="4" |Disease
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| ! colspan="3" rowspan="3" |Mechanism
| |
| ! colspan="6" |Clinical
| |
| ! colspan="9" |Paraclinical
| |
| ! rowspan="4" |Gold standard diagnosis
| |
| ! rowspan="4" |Other findings
| |
| |- | | |- |
| ! colspan="3" rowspan="2" |Symptoms | | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| ! colspan="3" rowspan="2" |Signs | | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| ! colspan="7" |Lab data
| |
| ! colspan="2" rowspan="2" |Imaging
| |
| |- | | |- |
| ! colspan="2" |ABG | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Gender |
| !U/A
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Female |
| ! colspan="3" |Electrolytes
| |
| ! rowspan="2" |Renin
| |
| |- | | |- |
| !↑ acid <br>production
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| !Loss of <br>bicarbonate
| |
| !↓ renal acid <br>excretion
| |
| !Fever
| |
| !Dyspnea
| |
| !Edema
| |
| !Toxic/ill
| |
| !BP
| |
| !Dehydration
| |
| !pH
| |
| !Serum AG
| |
| !Urine Cl<sup>−</sup>
| |
| !Cl<sup>−</sup>
| |
| !K<sup>+</sup>
| |
| !Na<sup>+</sup>
| |
| !US
| |
| !CT scan
| |
| |- | | |- |
| | rowspan="2" |Exogenous HCO<sub><big>3</big></sub><sup>−</sup> loads
| | ! rowspan="4" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age |
| |Acute alkali administration | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |0-70 |
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| |
| | | |
| |- | | |- |
| |Milk−alkali syndrome | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |71-80 |
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| | | |
| |- | | |- |
| | rowspan="5" |Gastrointestinal origin | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |81-90 |
| |Vomiting
| |
| |
| |
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| |
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| |
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| |
| |
| |
| |
| |
| |
| |
| | +
| |
| |
| |
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| |↓
| |
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| |
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| |
| |
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| |- | | |- |
| |Nasogastric tube suction | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>90 |
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| |
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| | +
| |
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| |↓
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| |- | | |- |
| |Gastric aspiration | | ! rowspan="5" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Hgb ('''g/dL)''' |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>17 '''g/dL''' |
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| |Congenital chloridorrhea | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15.5-17 '''g/dL''' |
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| |Villous adenoma | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-15.5 '''g/dL''' |
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| | rowspan="10" |Renal origin | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-11 '''g/dL''' |
| |Diuretics
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| |↓
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| |Posthypercapnic state | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<11 '''g/dL''' |
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| |Hypercalcemia/hypoparathyroidism | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |CrCl (mL/min) |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |30-60 mL/min |
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| |Recovery from lactic acidosis or ketoacidosis | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15-30 mL/min |
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| |Nonreabsorbable anions including penicillin, carbenicillin
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Albumin |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>3.5 g/dL |
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| |Hypomagnesemia | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≤3.5 g/dL |
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| | −
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| |Nl
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| |Hypokalemia | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |D-dimer |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≥1 µg/mL |
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| |Bartter's syndrome | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<1 µg/mL |
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| | −
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| |Nl
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| |Gitelman’s syndrome | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |ICU admission |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
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| |Renal artery stenosis | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Acute stroke on hospitalization |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
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| |↑
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| |Nl
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| |↑
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| | rowspan="2" |Endocrine
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |History of VTE |
| |Cushing's syndrome
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
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| |↑
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| |↓
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| |-
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| |Hyperaldosteronism
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| |↑
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| |Nl
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| |↓
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| |-
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| |Other
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| |Licorice ingestion
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| | −
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| |Nl
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| |↓
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| |} | |
| | |
| == Mixed Acid−Base Disorders ==
| |
| {| class="wikitable"
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| !Disorder
| |
| !Key features
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| !Examples
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| |-
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| |Metabolic acidosis & respiratory alkalosis
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| * High− or normal−AG metabolic acidosis
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| * Prevailing PaCO<sub>2</sub> below predicted value
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| * Lactic acidosis
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| * Sepsis in ICU
| |
| |-
| |
| |Metabolic acidosis & respiratory acidosis
| |
| |
| |
| * High− or normal−AG metabolic acidosis
| |
| * Prevailing PaCO<sub>2</sub> above predicted value
| |
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| * Severe pneumonia
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| * Pulmonary edema
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| |-
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| |Metabolic alkalosis & respiratory alkalosis
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| |
| * PaCO<sub>2</sub> does not increase as predicted
| |
| * pH higher than expected
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| | | |
| * Liver disease
| |
| * Diuretics
| |
| |- | | |- |
| |Metabolic alkalosis & respiratory acidosis
| | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
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| |
| * PaCO<sub>2</sub> higher than predicted
| |
| * pH normal
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| | | |
| * COPD on diuretics
| |
| |- | | |- |
| |Metabolic acidosis & metabolic alkalosis
| | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
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| |
| * Only detectable with high−AG acidosis
| |
| * ∆AG >> ∆[HCO<sub><big>3</big></sub><sup>−</sup>]
| |
| |
| |
| * Uremia with vomiting
| |
| |-
| |
| |Metabolic acidosis & metabolic acidosis
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| |
| * Mixed high−AG & normal−AG acidosis
| |
| * ∆[HCO<sub><big>3</big></sub><sup>−</sup>] accounted for by combined change in ∆AG and ∆Cl<sup>−</sup>
| |
| | | |
| * Diarrhea and lactic acidosis
| |
| * Toluene toxicity
| |
| * Treatment of diabetic ketoacidosis
| |
| |} | | |} |
| | <br style="clear:left" /> |
|
| |
|
| ==Related Chapters== | | ===Interpretation of the Padua Prediction Score=== |
| * [[Acid-base homeostasis|Acid–base homeostasis]]
| | The interpretation of the score is as follows: |
| * [[Acid-base imbalance|Acid–base imbalance]] | | * Score ≥ 4: High risk for VTE |
| * [[Arterial blood gas]] | | * Score < 4: Low risk for VTE |
| * [[Metabolic acidosis]]
| | ==References== |
| * [[Metabolic alkalosis]]
| |
| * [[Respiratory acidosis]]
| |
| * [[Respiratory alkalosis]]
| |
| * [[Anion gap]]
| |
| <references /> | | <references /> |